Virtual Colonoscopy - Colon Cancer Screening Procedure - Treatment and Cost

If you're 50 or older, your physician has probably recommended you to get screened for colorectal cancer. The reason: Colorectal cancer stands as the second highest cause of cancer related death in the United States. Since polyps can take years before becoming cancerous, with proper screening, colorectal cancer may be prevented.

Colon Cancer Screening

Until recently, there was only one way to screen for colorectal cancer, the traditional colonoscopy. This procedure involves a bowel cleansing process which lasts about a day, followed by sedation and a look through your colon with a five-foot-long probe. Not surprisingly, many people choose not to have this procedure. That's unfortunate, since 90% of such cancers may be prevented.

Colon Cancer Facts

  • Colon cancer is the 2nd leading cause of cancer death in the US, accounting for about 48,000 deaths a year.
  • Over 97,000 Americans will be diagnosed with colon cancer this year.
  • Colon cancer is the 3rd most common cancer among men and women in the US.
  • Men and women are at equal risk.
  • 90% of colon cancers occur over age 50.

Virtual Colonoscopy

There is a new less invasive technique called the Virtual Colonoscopy. A virtual colonoscopy involves no scopes but rather a scan of your colon. The Virtual Colonoscopy Scan takes hundreds of images of the abdomen, allowing radiologists to take a virtual tour through your colon. Bowel preparation is necessary but the good news is that the virtual colonoscopy is completely non-invasive, involves no sedation and no in-patient stay. You can choose to go back to work right after the procedure.

After the images are captured, a board certified radiologist will interpret your results and recommend a follow-up, if necessary. A follow-up may include a traditional colonoscopy.

This procedure is not recommended for individuals who have a history of colorectal cancer, Crohn's disease, or ulcerative colitis. Those individuals should consult their physician.

Virtual colonoscopy is the latest technique to help screen the colon for masses such as polyps/cancer. Unlike traditional colonoscopy, virtual colonoscopy is noninvasive and can be performed when traditional colonoscopy may not be possible/available. It is another option for individuals who do not want to undergo the traditional colonoscopy. The procedure evaluates the colon with a CT scan and makes use of sophisticated computer generated imaging techniques to reconstruct the inner surface of the colon. The 3D images are then read by trained radiologists.

Virtual Colonoscopy FAQ's

Why do we need a virtual colonoscopy?

There are many Americans who may be at risk for polyps, may have bleeding per rectum and may have some colonic problem. Yet these individuals are not properly evaluated. The best screening test to evaluate the colon is a regular colonoscopy. However, there are millions of patients and very few specialists who perform colonoscopy. Virtual colonoscopy is a newer and faster way to assess the colon and does not require any sedation.

Who should we have a virtual colonoscopy?

Those patients over the age of 50, those who have bleeding per rectum, those who have never had a barium enema or regular colonoscopy may be candidates for virtual colonoscopy. Any patients who have had a prior history of polyps may also be candidates for virtual colonoscopy.

What type of preparation is required for Virtual Colonoscopy?

The preparation is designed to cleanse the colon of all fecal material. Thus, the day before the procedure, all individuals are required to stay on a liquid diet, and take various laxatives and suppositories. Any remnant fecal material can interfere with adequate visualization of the inner colon. Frequently, patients are asked to take some oral barium tablets which will tag the fecal material and allow for discrimination from polyps.

Where is Virtual colonoscopy done?

Virtual colonoscopy is usually done in the radiology department at a hospital. The procedure takes about 10-15 minutes and requires no sedation. During the procedure, one is asked to lie on a table. Following this, a small plastic tube is placed in the rectum. Through this tube is pumped some air which distends the colon and rectum. The distended colon and rectum allow for better assessment of the colon by the CT scan. The table then moves into the scanner tunnel and cross sectional pictures are obtained. The patient is then asked to lie on his stomach and the process repeated. During the part where the table moves into the scanner, the individual is asked to hold his breath. This breath holding lessens the interference from body motions. The scanned pictures are then placed on a computer which generates 3-dimensional images of the colon.

Is virtual colonoscopy painful?

The procedure is best described as unpleasant sensation rather than painful. Having a small tube placed in the rectum is not comfortable. In addition, when air is pumped into the colon, most patients will complain of abdominal cramps. These cramps rapidly subside.

How long does Virtual Colonoscopy take?

The entire procedure takes 10-15 minutes and requires no sedation. At the end of the procedure, the patient may have a sensation of having to go to the bathroom and pass flatus (gas). All patients go home soon after the procedure is done. Patients can resume normal activities on the same day.

When are the results available?

The computer generates the images of the colon within a few minutes and these images are generally read on the same day by the radiologist. If the patient has had prior arrangements with the radiologist, the results can be discussed soon after the procedure. If the virtual colonoscopy is normal, a repeat study is recommended every 3 years.

What happens if my Virtual colonoscopy is abnormal?

If any abnormalities are discovered on virtual colonoscopy, it is very highly recommended that regular colonoscopy be done. If prior arrangements were made with a gastroenterologist, then the individual can undergo conventional colonoscopy on the same day. In most cases, the individual is referred to a physician who does the colonoscopy and the procedure is done later.

Can a virtual colonoscopy detect abnormalities outside the colon?

Virtual colonoscopy is designed primarily to look inside the colon. However, in some cases the technique may detect a pelvic or rectal mass, an aortic aneurysm or a prostate mass. Whenever such abnormalities are detected, additional investigations are always done to confirm the diagnosis.

What are advantages of a virtual colonoscopy?

VC is more comfortable than regular colonoscopy since no colonoscope is inserted into the colon. In addition, VC is a faster procedure, requires no sedation and the recovery time is minimal. The resolution of the images generated after VC are more detailed than those obtained with a barium enema.

What are the disadvantages of a virtual colonoscopy?

With Virtual colonoscopy tissue samples/biopsies cannot be obtained. So if any masses/polyps are detected, the patient must have a follow up regular colonoscopy. In addition, Virtual Colonoscopy cannot detect polyps less than 5-7mm. Current guidelines indicate that VC be performed every 3 years. In contrast a negative regular colonoscopy should be repeated every 10 years. It is important to understand that virtual colonoscopy has not replaced regular colonoscopy but is just another option for individuals who do not want to undergo colonoscopy.

What are alternatives to Virtual Colonoscopy?

Regular colonoscopy and barium enema are alternatives to virtual colonoscopy. Since the majority of these screening tests are not always covered by insurance agencies, it is best to start off with a barium enema.

Final Advice

In an era where medicine has become a big business, one should not fall into the trap of undergoing every study which is available. The best advice is to discuss the issue with your doctor and start of the simplest and most readily available test first.

By Staff
Updated: May 4, 2007

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